Medicare Benefits Schedule - Note TN.8.200

• An arthrodesis consists of joint preparation, removal of surrounding osteophytes, intraarticular joint correction and fixation by any means.
• Bone procedure items (48430, 48400, 48403, 48406, 48409, 48419, or 48420) are not to be claimed unless performed at a separate site to the arthrodesis.
• Neurolysis (39330), wound debridement (30023) and ganglion excision (30107) items are not to be claimed unless performed at a site separate to the arthrodesis site.

Related Items: 30023 39330 48400 48403 48406 48409 48419 48420 48430 49712 49740 49742 49744 49760 49776 49777 49778 49779 49780 49781 49789 49790 49791 49792 49793 49794 49795 49796 49797 49798 49814 49815 49845 49851 50118

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Multiple Operation Rule

Operation on foot:

(a) with either or both of the following:

(i) osteotomy of phalanx or metatarsal for correction of deformity;

(ii) excision of accessory bone or sesamoid bone; and

(b) including any of the following (if performed):

(i) removal of bone;

(ii) excision of surrounding osteophytes;

(iii) synovectomy;

(iv) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $375.45 Benefit: 75% = $281.60

(See para TN.8.168, TN.8.196, TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Osteotomy of phalanx of first toe or metatarsal, for correction of deformity, with internal fixation, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $589.90 Benefit: 75% = $442.45

(See para TN.8.168, TN.8.196, TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, for correction of deformity, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $375.45 Benefit: 75% = $281.60

(See para TN.8.168, TN.8.190, TN.8.196, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, for correction of deformity, with internal fixation, including any of the following (if performed):

(a) removal of bone;

(b) excision of surrounding osteophytes;

(c) synovectomy;

(d) joint release;

—one bone (H)

(Anaes.) (Assist.)

Fee: $589.90 Benefit: 75% = $442.45

(See para TN.8.168, TN.8.190, TN.8.196, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Osteotomy of distal tibia, for correction of deformity, without internal or external fixation, including any of the following (if performed):

(a) excision of surrounding osteophytes;

(b) release of joint;

(c) removal of bone;

(d) synovectomy;

—one bone (H)

(Anaes.) (Assist.)

Fee: $718.45 Benefit: 75% = $538.85

(See para TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Osteotomy of distal tibia, for correction of deformity, with internal or external fixation by any method, including any of the following (if performed):

(a) excision of surrounding osteophytes;

(b) release of joint;

(c) removal of bone;

(d) synovectomy;

—one bone (H)

(Anaes.) (Assist.)

Fee: $911.65 Benefit: 75% = $683.75

(See para TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Excision of one or more osteophytes of the foot or ankle, or simple removal of bunion, including any of the following (if performed):

(a) capsulotomy;

(b) excision of surrounding osteophytes;

(c) release of ligaments;

(d) removal of one or more associated bursae or ganglia;

(e) removal of bone;

(f) synovectomy;

—each incision (H)

(Anaes.) (Assist.)

Fee: $305.65 Benefit: 75% = $229.25

(See para TN.8.196, TN.8.199, TN.8.200, TN.8.201, TN.8.292 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of joint of hindfoot, by any method, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—one joint (H)

(Anaes.) (Assist.)

Fee: $892.65 Benefit: 75% = $669.50

(See para TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $1,072.50 Benefit: 75% = $804.40

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Revision of arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

(e) removal of hardware;

(f) neurolysis;

(g) osteotomy of non-union or malunion;

other than a service associated with a service to which item 30023 applies that is performed at the same site

(H)

(Anaes.) (Assist.)

Fee: $1,608.90 Benefit: 75% = $1,206.70

(See para TN.8.199, TN.8.200, TN.8.283 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $1,518.80 Benefit: 75% = $1,139.10

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Revision of arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

(e) removal of hardware;

(f) neurolysis;

(g) osteotomy of non-union or malunion;

other than a service associated with a service to which item 30023 applies that is performed at the same site

(H)

(Anaes.) (Assist.)

Fee: $2,278.25 Benefit: 75% = $1,708.70

(See para TN.8.199, TN.8.200, TN.8.283 of explanatory notes to this Category)

Multiple Operation Rule

Reconstruction of major tendon of ankle, by any method, including:

(a) osteotomy of hindfoot, with internal fixation; and

(b) lengthening of major tendon of ankle; and

(c) any of the following (if performed):

(i) synovial biopsy;

(ii) synovectomy;

(iii) adjacent tendon transfer;

(iv) turn down flaps;

other than a service associated with a service to which item 49718 applies (H)

(Anaes.) (Assist.)

Fee: $1,126.30 Benefit: 75% = $844.75

(See para TN.8.200, TN.8.204 of explanatory notes to this Category)

Multiple Operation Rule

Arthroereisis of subtalar joint, including any of the following (if performed):

(a) capsulotomy;

(b) synovectomy;

(c) joint debridement

(H)

(Anaes.) (Assist.)

Fee: $402.25 Benefit: 75% = $301.70

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Revision of arthrodesis of joint of hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

(e) removal of hardware;

(f) neurolysis;

(g) osteotomy of non‑union or malunion;

other than a service associated with a service to which item 30023 applies that is performed at the same site—may only be claimed once per joint (H)

(Anaes.) (Assist.)

Fee: $1,339.05 Benefit: 75% = $1,004.30

(See para TN.8.199, TN.8.200, TN.8.224, TN.8.283 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of joint of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint;

—one joint (H)

(Anaes.) (Assist.)

Fee: $792.85 Benefit: 75% = $594.65

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—2 joints (H)

(Anaes.) (Assist.)

Fee: $1,189.30 Benefit: 75% = $892.00

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—3 joints (H)

(Anaes.) (Assist.)

Fee: $1,387.45 Benefit: 75% = $1,040.60

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints;

—4 joints (H)

(Anaes.) (Assist.)

Fee: $1,585.60 Benefit: 75% = $1,189.20

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Revision of arthrodesis of joint of midfoot, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of ostephytes at joint;

(e) removal of hardware;

(f) osteotomy of non-union or malunion;

—one joint (H)

(Anaes.) (Assist.)

Fee: $1,189.30 Benefit: 75% = $892.00

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Bilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $1,273.35 Benefit: 75% = $955.05

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Revision of arthrodesis of first metatarsophalangeal joint, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of exostosis at joint;

(e) removal of hardware;

(f) osteotomy of non-union or malunion

(H)

(Anaes.) (Assist.)

Fee: $1,106.00 Benefit: 75% = $829.50

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis of hallux interphalangeal or lesser metatarsophalangeal joint, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joint

(H)

(Anaes.) (Assist.)

Fee: $501.45 Benefit: 75% = $376.10

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—one or 2 toes (H)

(Anaes.) (Assist.)

Fee: $563.25 Benefit: 75% = $422.45

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—3 toes (H)

(Anaes.) (Assist.)

Fee: $657.10 Benefit: 75% = $492.85

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—4 toes (H)

(Anaes.) (Assist.)

Fee: $750.95 Benefit: 75% = $563.25

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—5 toes (H)

(Anaes.) (Assist.)

Fee: $844.80 Benefit: 75% = $633.60

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—6 toes (H)

(Anaes.) (Assist.)

Fee: $938.70 Benefit: 75% = $704.05

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—7 toes (H)

(Anaes.) (Assist.)

Fee: $1,032.55 Benefit: 75% = $774.45

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) joint release;

(d) synovectomy;

(e) removal of osteophytes at joints;

—8 toes (H)

(Anaes.) (Assist.)

Fee: $1,126.45 Benefit: 75% = $844.85

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Triple arthrodesis of hindfoot joints, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints

(H)

(Anaes.) (Assist.)

Fee: $1,562.25 Benefit: 75% = $1,171.70

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

Unilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed):

(a) capsulotomy;

(b) joint release;

(c) synovectomy;

(d) removal of osteophytes at joints

(H)

(Anaes.) (Assist.)

Fee: $737.40 Benefit: 75% = $553.05

(See para TN.8.199, TN.8.200, TN.8.223 of explanatory notes to this Category)

Multiple Operation Rule

Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal (or both) joints of lesser toe, including any of the following (if performed):

(a) internal fixation, by any method;

(b) capsulotomy;

(c) tendon lengthening;

(d) joint release;

(e) synovectomy;

(f) removal of osteophytes at joints;

—one toe (H)

(Anaes.) (Assist.)

Fee: $493.25 Benefit: 75% = $369.95

(See para TN.8.199, TN.8.200 of explanatory notes to this Category)

Multiple Operation Rule

WOUND OF SOFT TISSUE, traumatic, deep or extensively contaminated, debridement of, under general anaesthesia or regional or field nerve block, including suturing of that wound when performed

(Anaes.) (Assist.)

Fee: $371.45 Benefit: 75% = $278.60 85% = $315.75

(See para TN.8.6, TN.8.200, TN.8.283 of explanatory notes to this Category)

Multiple Operation Rule

Neurolysis by open operation without transposition, other than a service associated with:

(a) a service to which item 39321, 39328, 39329, 39332, 39336, 39339, 39342, 39345, 49774 or 49775 applies; or

(b) a service to which item 30023 applies that is performed at the same site

(H)

(Anaes.) (Assist.)

Fee: $315.30 Benefit: 75% = $236.50

(See para TN.8.196, TN.8.200, TN.8.254, TN.8.283 of explanatory notes to this Category)